Impact of Pharmacist-Driven Heart Failure in-Home Counseling on 30-Day Readmission Rates

Abstract

Purpose/Objective: This study examines the impact of a pharmacist-driven intervention specific to heart failure patients with the goal of reducing readmission rates and improving quality of life in this population. Findings/Conclusions: A total of 21 patients were included in the study. Twelve patients were female and 9 were male. The mean age was 76 years with a range of 65–93 years. Two of the 21 patients were readmitted within 30 days. One of the 2 readmitted patients died soon after admission was in the final stages of his or her disease and passed away soon after; it is unlikely for a home visit to have altered their path. This study did not meet the goal sample size due to some unforeseen limitations. However, the limited data that were obtained suggest a strong basis for further research. Implications for Case Management Practice: During a patient's transition in care from hospital to home, he or she is most vulnerable for complications and readmission. Intervention during this time will not only improve patient care and quality of life but also contribute to a notable cost savings for each prevented readmission. Pharmacist intervention, as part of the health care team, during this tenuous time has shown to make a valuable impact.

Care Coordination Processes in Transitional Care for Patients With Heart Failure

“…Four studies were randomized controlled trials, 33,35,37,38 and the remainder used quasi-experimental or retrospective observational designs 34,36,39–49 . Sample sizes ranged from 21 participants 40 to 28 693 participants 38 . Most of the studies (n = 13) recruited more than 100 participants 33–38,40,41,43–47 .…”

“…Sample sizes ranged from 21 participants 40 to 28 693 participants 38 . Most of the studies (n = 13) recruited more than 100 participants 33–38,40,41,43–47 . The mean age of participants ranged from 67 years 47 to 81 years 45 .…”

“…No consistent duration of care coordination processes was found across studies (Table 1); however, most interventions (n = 10) involved care coordination processes that occurred both during and after hospitalization 36–41,43,46,48,49 . Interventions were initiated at different points along the hospitalization trajectory, including shortly after admission (n = 4), 41,42,46,47 right before or at discharge (n = 8), 36–40,43,48,49 and within 2 days 33,34,44 or 2 weeks 35,45 after discharge.…”

“…Interventions were initiated at different points along the hospitalization trajectory, including shortly after admission (n = 4), 41,42,46,47 right before or at discharge (n = 8), 36–40,43,48,49 and within 2 days 33,34,44 or 2 weeks 35,45 after discharge. Likewise, the duration of transitional care interventions after hospital discharge varied: 1 or less (n = 4), 33,34,44,48 2 weeks (n = 1), 45 4 weeks or 1 month (n = 4), 40,43,46,49 6 weeks (n = 1), 35 3 months (n = 2), 37,39 and 6 months (n = 2) 38,41 …”

“…We classified the setting of providers who only delivered care remotely based on their employer. Interventionists commonly interacted with both hospital- and community-based providers (n = 9) 36–42,46,48,49 . Categorizing the intervention as hospital or community based was determined by the interventionists' setting.…”